Priority Measures Research Articles

Predictors of bleeding from esophagus veins in patients with liver cirrhosis

Aim: to identify clinical and laboratory predictors of bleeding from the esophageal veins in patients with liver cirrhosis and evaluate their practical significance. Materials and methods. The study materials were the results of an examination of 50 patients treated in the gastroenterology department for liver cirrhosis and 160 patients in surgical departments hospitalized for bleeding from esophageal varices due to liver cirrhosis. All patients were subjected to a standard set of general clinical examinations, ultrasound examination of the abdominal organs, and videoesophagogastroduodenoscopy. Results. When comparing patients with cirrhosis of the liver with and without bleeding from the veins of the esophagus, a statistically significant difference was revealed between the groups in the gender and age composition, blood bilirubin level, and de Ritis coefficient. At the same time, no differences were found in the etiology and severity of liver cirrhosis, blood protein levels, the diameter of the portal and splenic veins, and the proportion of patients with ascites. Conclusions. The detection of a de Ritis coefficient equal to or exceeding 1.8 in a patient with liver cirrhosis can be considered a predictor of a high risk of bleeding from the esophageal veins (sensitivity of the parameter 60.87%, specificity 93.94%) and can be recommended for identifying those in need of priority measures primary prevention.

РАДІАЦІЙНИЙ СТАН ЗОНИ ВІДЧУЖЕННЯ В 2023 РОЦІ ЗА РЕЗУЛЬТАТАМИ РАДІАЦІЙНО-ЕКОЛОГІЧНОГО МОНІТОРИНГУ

The article presents results of radiation and environmental monitoring in the Exclusion Zone for the year 2023, after de-occupation of the territory, which was carried out in accordance with the current regulation of work, with the exception of objects on which it is temporarily impossible to carry out work due to the lack of safe access. In 2022, due to the full-scale invasion of russian federation, radiation monitoring of the environment was interrupted, monitoring of radiation-hazardous objects and environmental components of the Exclusion Zone was not carried out. Implementation of priority measures to restore the radiation and environmental monitoring system in the Exclusion Zone, after occupation by russian troops, made it possible to resume the work of the automated radiation monitoring system points, to create an additional network of measurement of gamma radiation indicators in the Exclusion Zone, to restore work of the central analytical laboratory and to restore the work of aspiration units. Thus, the enterprise resumed obtaining the necessary data on the dose rate of gamma radiation, information on the radiation state of the surface layer of the atmosphere, radiation state of surface and underground waters, radiation state of landscapes and places of residence of self-settlers. According to the results of radiation and environmental monitoring in the Exclusion Zone in 2023, important analytical data were obtained: - Maximum power values of the ambient dose equivalent of gamma radiation are characteristic of the territories in the northern and western 'traces' of radioactive fallout; - Radiation state of the Exclusion Zone air environment and its dynamics during 2023 were determined by the nature of surface contamination of the territory, man-made and biological factors, as well as meteorological conditions. Control levels exceeding by 2.5 times of 137Cs volumetric activity in the air was recorded in Chornobyl; - Surface waters remain an important route of radionuclide removal beyond the Exclusion Zone. Removal of 90Sr from Pripyat River in the area of Chornobyl in 2023 was at a level that was 2.4 times higher than the average value for the last 5 years; - As a result of observations of the radiation state of underground waters, it was determined that the average value of radionuclide contamination of eocene and cenomanian-lower cretaceous water-bearing complexes does not exceed 1 Bq/m3 for 137Cs and 5.7 Bq/m3 for 90Sr; - Monitoring results at landscape landfills indicate that the most contaminated component of the environment is the top layer of soil cover; - Radiation survey results of unauthorized residence places of the population in the Exclusion Zone showed that over the years there is an increase in the intake of 90Sr in the food products of 'self-settlers'.

Pay more attention to vaccination to protect the health of the elderly

Vaccination has been implemented as a priority measure to control infectious diseases worldwide. The aging of the global population continues to intensify, and the process and level of aging in China are more prominent. As age increases, the immune function of people gradually declines, and the consequences of infectious diseases such as influenza, pneumococcal disease, and shingles are more severe in the elderly, which can exacerbate existing underlying diseases, leading to higher medical costs. In the process of achieving healthy aging, it is very necessary to protect vulnerable elderly people through vaccination. Despite the undeniable protective effects of the influenza, pneumococcal, and shingles vaccines for the elderly, coupled with excellent safety and significant health economic benefits, the current vaccination rates for these vaccines among the elderly in China remain low. Some factors, such as insufficient awareness of the necessity of vaccination, concerns about vaccine adverse reactions, lack of systematic and effective recommendations, and imperfect accessibility of vaccination services, affect the popularization of preventive vaccination among the elderly in China. This situation urgently calls for the attention of society as a whole, in order to maximize the role of vaccines in safeguarding the health of the elderly.

PROMOVENDO O BEM-ESTAR PSICOLÓGICO: ESTRATÉGIAS DE PREVENÇÃO DE DEPRESSÃO EM IDOSOS DE 60 A 80 ANOS

Aging is a normal and natural phase of society's development, deeply linked to health and illness conditions, and influenced by neurobiological, genetic, functional, and sociocultural factors. Quality of life plays a central role in characterizing aging as healthy or pathological, making it clear that an individual's psychological health is a result of the context in which he or she lives. Therefore, this study aimed to analyze the nursing strategies adopted to prevent depression in elderly individuals aged 60 to 80 years. This is a narrative review study, carried out through research in the Virtual Health Library (VHL) and Google Scholar, using the following descriptors: depression AND elderly AND nursing AND prevention. The eligibility criteria adopted were: complete works that addressed the topic between the years 2019 and 2024. Dissertations, theses, theoretical essays, and experience reports were excluded. In the end, eight studies were selected. Among the strategies used by nurses, the following are mentioned: encouraging the maintenance of Activities of Daily Living (ADLs); encouraging the active participation of the social support network; keeping the home environment well ventilated; cleaning and disinfecting frequently touched surfaces, such as bed headboards, remote controls, doorknobs, cell phones and canes, with 70% alcohol; and promoting a healthy diet, accompanied by good fluid intake, as priority measures to reduce the chances of contamination by COVID-19. Thus, it is concluded that health professionals need to redefine the provision of care and attention to the elderly in health services, in addition to promoting the training of the nursing team to meet gerontological needs more adequately.

Determining the leaders of Ukraine’s insurance market based on the adaptation of the DEA method

The escalating wartime risks in Ukraine has led to a rapid reduction in insurance coverage in life and non-life segments. The purpose of the study is to rank Ukraine’s insurance companies based on an adaptation of the DEA method to the insurance market conditions. The study utilized the Supervisory Statistics of the National Bank of Ukraine as data. The study also used ranking of insurance companies based on technical efficiency criteria. The output indicators include the profitability of total capital (Output1) and the occupied share of the insurance market (Output2). The input indicators comprise the volume of total assets of insurers (Input1), the share of equity capital in assets (Input2), the level of gross payments (Input3), and the level of payments to insurance reserves (Input4). The ranking of insurance companies is based on minimizing the distance of each from the bounds of technical efficiency by solving a set of optimization problems. Based on the modeling results, a list of market leaders (7 companies) was formed for the end of the third quarter of 2023. They served nearly 37% of the insurance market in Ukraine, accumulating 41.5% of the total assets of this financial market sector. So, the primary issue for insurance companies is the loss of solvency due to the absence of adequate levels of insurance reserves. Therefore, priority measures should include strengthening regulatory constraints in this financial market segment to facilitate its qualitative renewal.

Evolution of critical nutrients (salt, sugars and saturated fats) in Spanish foods and beverages in the last 25 years

Non-communicable diseases (cardiovascular diseases, cancer, chronic respiratory diseases, diabetes, etc.) are the leading cause of death worldwide, accounting for 71 % of global deaths. The risk factors for all of them are closely linked to lifestyle and in particular to diet. For this reason, public health policies in European Union countries, in line with World Health Organization (WHO) recommendations, include in their priority measures actions aimed at promoting healthier food environments. One of these measures are policies for the reformulation of processed foods to reduce critical nutrients: salt, saturated fats, trans fats and added sugars. In Spain, as part of the NAOS Strategy, food reformulation measures have been implemented since 2008. Of all of them, the Plan de Colaboración para la Mejora de la Composición de Alimentos y Bebidas y otras Medidas 2020 stands out, which has led to a reduction in the content of salt, sugar, saturated and total fat in foods belonging to 57 subcategories marketed by the main food manufacturing and marketing companies from 2016 to 2021. Despite this, to date no population-based study has been conducted to test the impact of the measure on the diet of the Spanish population. The present article, by way of example, shows results of the theoretical estimation of total sugar intake in the pre-reformulation period (2016) and post-reformulation period (2024) based on the consumption of beverages in Spain. Data highlight that reformulation policies could have positive effects that need to be evaluated in representative studies of the Spanish population assessing the overall diet, in order to solidly confirm their positive effects on the population's diet.

Сучасний стан банківського кредитування суб’єктів малого підприємництва сфери оборони в україні

The article examines the current state of bank lending to small businesses in the defense sector in Ukraine. An analysis of the component expenditures of the state budget in 2021–2024 has been carried out; in particular, the share of defense expenditures has been determined. It has been found that defense production requires working capital for the purchase of components, covering the gap between the advance and the need for funds, relocation of enterprises, and provision of uninterrupted/alternative power sources. An analysis of current lending programs for small and medium-sized enterprises managed by Ukrainian banks in 2023 (JSC CB “PrivatBank”, JSC “Oschadbank”, JSC “Sense Bank”, JSC “Ukrgasbank”, JSC OTP BANK, JSC “Taskombank”, JSC “KredoBank”) has been carried out. The structure and volumes of loans issued to entrepreneurs within the framework of the Affordable Loans at 5-7-9% state program during the period of martial law have been studied, and their sectoral structure indicates that the funds have been being directed chiefly to agriculture – 52%, wholesale trade – 17% and food industry – 8%. A range of problems faced by small businesses in the defense sector in the process of bank lending has been outlined, in particular: lack of contracts with the Ministry of Defense of Ukraine, the need for weapon use approval, short-term nature, obtaining permission to export weapons, high interest rates, military risks, lack of collateral property, etc. The priority measures for expanding lending to the defense sector in Ukraine by the National Bank of Ukraine, the Ministry of Strategic Industries of Ukraine, and the Ministry of Finance of Ukraine have been systematized. It has been proposed that preferential state programs for bank lending be introduced to small businesses in the defense sector. Keywords: bank lending, small business, defense sector, support program, state program.

Mercury removal from water: insights from MOFs and their composites

Abstract Mercury pollution is disturbing, human health by causing many serious types of diseases. Therefore, elimination of mercury from water bodies is very important that is gaining attention among researchers, and researchers are setting priority measures to make mercury free water. One such measure is the use of MOFs and their composites which are extensively applied for the removal of Hg from water, because of displaying majestical characteristics like high water stability, tunable porosity and surface area as well as easy to synthesize. In this review, we discussed the elimination of Hg ions using MOFs and their composites. We also discussed how MOFs and their composites can be modified that can be more reliable and efficient for removal of pollutants from water particularly mercury ions. Furthermore, we explored the challenges in the application of MOFs and present measures to boost the application range of MOFs. In the same way we also discussed potential of MOFs and their composites to overcome difficulties and research directions for the elimination of Hg (II) ions from water bodies. We expect that this review will offer inclusive and clear understanding to researchers about MOFs and their composite for practical applications to remove mercury from water bodies.

Monitoring of atmospheric air quality in cities participating in the federal project “Clean Air” of the Far Eastern Economic Region

Introduction. Air pollution over 2021 was associated with about 6.7 thousand additional deaths and almost 1.1 million additional cases of illness among the Russian population. Conducting an atmospheric air quality assessment for the subsequent selection of priority measures aimed at reducing its negative impact on public health is the main task of the Clean Air federal project. The aim of the study is to assess the management of monitoring and air quality in the cities of Komsomolsk-on-Amur, Petrovsk-Zabaykalsky, and Ussuriysk before the implementation of the federal project “Clean Air”. Materials and methods. The monitoring programs for atmospheric air quality, the results of laboratory studies for 2021 were used. The number, location of observation posts, volumes, frequency of sampling, a list of indicators, the total number of samples, the number of samples exceeding the MPC, average annual, maximum one-time concentrations of pollutants were analyzed. Results. In Komsomolsk-on-Amur, atmospheric air quality monitoring was carried out at 4 stationary and 3 route posts, Ussuriysk – 1 mobile and 1 stationary post, Petrovsk-Zabaikalsky – 1 stationary post. All studied cities are characterized by systematic excesses of hygienic standards for specific indicators. The level of air pollution in the city of Komsomolsk-on-Amur is assessed as very high, in the cities of Ussuriysk and Petrovsk-Zabaikalsky – low. Despite the low level of air pollution, these towns are characterized by systematic excesses of hygienic standards of some indicators. Limitations. The study analyzed the management of monitoring and the results of laboratory studies of atmospheric air only in the cities of Komsomolsk-on-Amur, Ussuriysk, Petrovsk-Zabaykalsky. Conclusion. The existing monitoring system in the Ussuriysk, Komsomolsk-on-Amur and Petrovsk-Zabaykalsky cities fails to allow an objective assessing of the quality of atmospheric air and its impact on public health. To objective evaluation of the impact of atmospheric air quality on the health of the population of the studied cities, measures to optimize the monitoring system were proposed.

КАБИНЕТЫ КУЛЬТУРЫ ЗДОРОВЬЯ И МУЗЫКОТЕРАПИИ В РАМКАХ НОВОЙ ПАРАДИГМЫ ЗДОРОВЬЕСБЕРЕЖЕНИЯ СИСТЕМЫ ШКОЛЬНОГО ОБРАЗОВАНИЯ

This article analyzes the reasons for the serious increase in morbidity among schoolchildren, which is demonstrated by modern statistics. Many of the external challenges that negatively affect children's health are presented: environmental problems, aggressive information, and other global problems. Obviously, their solution is complicated by its long-term nature, as it requires large-scale efforts at the state level. Meanwhile, the situation can be significantly improved in the short term. As a priority measure, the author recommends focusing efforts on the comprehensive correction of destructive factors within schools, such as a stressful environment, spiritual and moral underdevelopment, and a lack of literacy in matters of a healthy lifestyle for the students themselves. To effectively solve these problems, it is proposed to open rooms for health culture and music-art therapy, which should become a conductor of the main idea of the new paradigm—from general culture to the art of health care and general well-being. The foundation for achieving this goal is the existing retraining programs, which make it possible to train qualified specialists for such offices from among teachers, psychologists, and people with any higher education. At the same time, the advanced technologies of scientific music and art therapy presented in the article play an important role in preserving health, increasing adaptive capabilities, and harmoniously developing the schoolchild’s personality.

MANAGEMENT OF THE SDGs ACHIEVEMENT PROCESS IN LNTU SCIENTIFIC ACTIVITIES

The article is devoted to considering green standards for scientific research activities, and a system of priority measures and the achievement of key performance indicators reasoning. A self-assessment of SDGs achievement according to Green standards at LNTU in 2023 has been conducted, which includes environmental, social, and economic responsibility, as well as components of education and research. The hypothesis of the consistency of experts' views during the self-assessment of compliance with green standards of scientific activities has been proven by the Kendall concordance coefficient.The results of the self-assessment of compliance with green standards of scientific activities at LNTU are the basis for forming strategic actions to achieve SDGs. A methodology for forming an archetypal scenario of interaction between LNTU and SDGs has been proposed for use: tolerant, uncommitted, paternalistic, or transformational. The implementation of the transformational archetypal scenario of interaction between LNTU contains priorities for improving policies and plans.

Innovative Development of General Secondary Education Institutions in the Context of STEM Education Implementation

The article outlines the main tasks, challenges and priority measures to be taken for the effective innovative development of general secondary education institutions in the context of the introduction of STEM education. The authors define STEM education as a relevant pedagogical innovation that promotes comprehensive development, formation of key competencies of students and identification of their innovative potential, as well as provides vocational training for young people in the scientific and technical field, and thereby contributes to the development of the economy and sustainable development of the State. The stages and ways of implementing STEM education, which will lead to successful innovative development of general secondary education institutions, which involves the development of organizational culture, educational policy of the educational institution, and management of the educational process, are substantiated. Recommendations are provided that will contribute to the modernization of the educational process of general secondary education institutions in general and the implementation of the main tasks of STEM education.

Hemostasis parameters in patients with arterial hypertension, multifocal atherosclerosis and risk factors

Aim. To determine the features of hemostasis system disorders and the possibility of their correction in patients with arterial hypertension (AH) and multifocal atherosclerotic lesions (MFA) with risk factors indicated.Materials and methods. The study included 135 patients (mean age 53.7 ± 7.76 years), including 80 patients with controlled AH stage and II (group 1) and 55 patients with controlled AH stage III who had ischemic stroke (group 2). Among all patients studied, 33 patients (24.4 %) were smokers. All 135 patients received comparable antihypertensive, antiplatelettherapy (acetylsalicylic acid at a dose of 100 mg/day), had MFA and target lipid spectrum values.Results. Procoagulant shifts are noted already in patients with AH stage I and II, especially in the presence of smoking. Such indices of global thrombodynamics test as initial clot growth rate, average clot growth rate, clot size significantly exceed the reference values and indicate high prothrombogenic potential in patient with AH and MFA. Prescription of dual antiplatelet therapy allows normalization of identified disorders. Presence of risk factors (smoking) aggravates existing hemostasis disorders in patients with AH and MFA.Conclusion. Smoking cessation, optimization of risk factors and complex antihypertensive, hypolipidemic and antithrombotic therapy are the basis of treatment of patients with AH and MFA and can be considered as priority measures to reduce morbidity and mortality in this patient population.

Assessment of Landfills and their Impact on the Soil: a Local Study in Ukraine

Landfills are widely utilised for waste disposal due to their economic advantages and ease of implementation compared to alternative methods. However, landfills exert significant environmental and health impacts on adjacent agricultural land. Accumulation of heavy metals in soil is a risk to ecological and food safety. Methodological approaches to assess and mitigate the impact of landfills on agricultural land are essential for ensuring sustainable land use practices and safeguarding human health. In this study, landfills were assessed at the local level, and the hazard level was classified according to it. A set of priority measures for restoring technogenic disturbed areas and minimising their impact on agricultural land was determined. The need to select a set of innovative, ecologically oriented methods for remediation of landfills, depending on the type and degree of soil contamination, was identified in context of ensuring environmental and food security.

Ambulatory Quality Improvement Despite COVID-19: Blueprint for a Successful System for Continuous Improvement.

In this article, we describe our experience developing and implementing a multipronged approach to improve performance across a strategic subset of quality measures within primary care. Detailed techniques include data visualization and analytics, process reengineering, team engagement, visual project management, continuous improvement methods and training, and incentives and recognition. We achieved positive change across 12 high priority measures which we deemed the "High Value Framework (HVF)" by fostering a collaborative, nonpunitive, problem-solving culture. We focused on measures that had the greatest potential for impact from a clinical, reimbursement, and reputational perspective. More importantly, we sustained gains despite the challenges posed by the COVID-19 pandemic, thereby demonstrating programmatic resilience and high process reliability. This systematic approach serves as a practical blueprint for other healthcare entities seeking to navigate the complexities of quality improvement in a dynamic environment. The model provides a strategic framework for prioritizing and standardizing quality measures, effectively engaging stakeholders, and managing organizational change. Our model emerged from a need to address real-world operational challenges, rather than as an academic or theoretical exercise, and was developed independently of existing literature on measure prioritization and standardization at the time of its inception.

Forest firefighting technology: Strategic water reservoir placement for terrestrial and aerial vehicles

Forest fires pose significant environmental, economic, and social threats to protected areas. Understanding their destructive potential is crucial for effective risk management. Two key factors in firefighting are water availability and emergency response networks. This study aimed to determine optimal locations for water reservoirs, supporting terrestrial and/or aerial firefighting in the Caparaó National Park within the Brazilian Atlantic Forest biome. Geotechnological tools (fuzzy logic, Euclidean distance, network analysis) were employed to identify strategic reservoir locations, considering land use, slope, proximity to roads, watercourses, and fire risk. The application of these methodologies revealed that terrestrial firefighting alone fell short of meeting the specified demand, capable of addressing at most 92.13 % of demand within the longest available timeframe (20 min). Additionally, the number of reservoirs required for this method was significantly higher (724 reservoirs) compared to aerial firefighting (42 reservoirs). Analyzing the investment needed for reservoir construction relative to the covered area in each evaluated scenario, it is evident that the terrestrial approach incurs a significantly higher cost ($40,664.35.km−2) than the aerial approach ($2358.98.km−2). From these results, it was concluded that the use of geotechnological tools is efficient in identifying strategic water reservoir locations for replenishing firefighting vehicles, and all methodologies support the creation of priority measures and plans for firefighting, proving to be viable, applicable, replicable, and adaptable to any other protected areas and economically significant regions.

Analysis of road traffic accidents and casualties associated with electric bikes and bicycles in Guangzhou, China: A retrospective descriptive analysis

IntroductionElectric bicycles (e-bikes) and bicycles in large Chinese cities have recently witnessed substantial growth in ridership. According to related accident trends, this study analyzed characteristics and spatial distribution in the period when e-bike-related accidents rapidly increased to propose priority measures to reduce accident casualties. MethodsFor e-bike- and bicycle-related accident data from the Guangzhou Public Security Traffic Management Integrated System, linear regression was used to examine the trends in the number of accidents and age-adjusted road traffic casualties from 2011 to 2021. Then, for the period when e-bike-related accidents rapidly increased, descriptive statistics were computed regarding rider characteristics, illegal behaviors, road types, collision objects and their accident liability. One-way analysis of variance (ANOVA) followed by Bonferroni's multiple comparison test. P < 0.05 was considered statistically significant. Finally, the density distribution of accidents was presented, and Moran's I (MI) was used for assessing spatial autocorrelation. Hotspots were identified based on an optimized hotspot analysis tool. ResultsBetween 2011 and 2021, the number of accidents and casualty rate (per 100,000 population) increased for e-bikes but decreased for bicycles. After 2018, e-bike-related accidents increased rapidly, and bicycle-related accidents plateaued. Accident hotspots were concentrated in central city areas and suburban areas close to the former. Three-quarters of accidents occurred in motorized vehicle lanes. Most occurred on roads without physically segregated nonmotorized vehicle lanes. More than three-fifths of the accidents involved motor vehicles with at least four wheels. The prevalence (per 100 people) of casualties among e-bike rider victims and cyclist victims accounted for 92.0 % and 96.5 %, respectively. A total of 71.6 % of e-bike-related accidents involved migrant workers. Riding in motorized vehicle lanes was the most common illegal behavior. ConclusionsAlthough e-bike-related and bicycle-related accidents presented similar characteristics, the sharp increase in e-bike-related accidents requires attention. To improve e-bike safety, governments should develop appropriate countermeasures to prevent riders from riding on motorways, such as improving road infrastructure, adjusting the driver's license system and addressing priority control areas.

Fiscal dominants of military financing

Long-term military aggression has required updating approaches to budget revenue forma­tion to increase the fiscal effectiveness of taxes and ensure budget sustainability. The article is aimed to substantiate the main priorities for boosting the efficiency of the central budget revenue formation system in combating full-scale military aggression, which involves compliance with the principle of fiscal suffi­ciency in financing defense and security needs and fostering economic recovery. Syste­matic and logical approaches were used in the article. Various methods were applied, including gene­ralization, comparison, analysis and syn­the­sis, scientific abstraction and expert eva­luations. The USA’s experience in the field of budget revenues formation during wars shows that the authorities tried to design the taxpayer’s trust and ensure a fair cost for conducting a war for every citizen. The classic measures were increased tax rates on income and profits, and the active sale of government bonds. Great Britain has applied identical measures. The budget revenues formation policy has demon­strated significant changes since the full-scale invasion. The percentage of GDP redistribution through the central budget revenues in 2023 equaled 41.76%. The main features of tax revenues shaping (into a central budget) in 2022–2023 have been identified. Priority measures to raise the fiscal significance of tax revenues have been substantiated. This concerns the decrease of the shadow part of the gambling business; the excise goods markets; and labor incomes. In addition, the prerequisites for introducing a progressive personal income tax scheme have been determined.

RISKS IDENTIFYING AND ASSESSMENT PECULIARITIES IN BUSINESS PLANNING PROCESS

The scientific article discusses problematic aspects of identifying and assessing risks at the stage of developing business plans. It was determined that changes in the economic environment of enterprises require the formation of new approaches and means of solving economic problems. One of the effective ways to solve this problem is to develop a business plan. This document should be considered both a management tool of the business entity and a means of attracting financing. The specifics of business planning are defined, the main reasons that lead to the development of a business plan are considered.&#x0D; It is noted that risks are an important element that must be paid attention to in business planning. The interpretation of the term "risk" in the scientific literature is generalized. It was determined that the presence of risk in the business plan is a forming factor of uncertainty. The study points to the presence of risks as a mandatory and undeniable element of enterprise activity in modern conditions. Risk assessment is a mandatory structural element of a typical business plan.&#x0D; It is indicated that each business plan is individual and unique. It is proposed to detail the risks not in a separate section "Risks", but in the section of the main sections of the business plan: market analysis, marketing plan, organizational plan and management, production plan, financial plan, which will allow group all existing risks, detail them and develop priority measures to neutralize them.&#x0D; The main types of risks that may arise in the main sections of the business plan are revealed. It was determined that the systematization of types and groups of risks by sections is an important tool for their effective management, because it helps to choose individual approaches to assessment, measurement, forecasting and selection of response measures.&#x0D; As a result, it is proposed to form an appropriate table of risks and means of their neutralization, which will allow to show the investor or an interested person that the applicant is informed and able to cope with the risks and threats of the project

Chronic diseases and determinants of community health services utilization among adult residents in southern China: a community-based cross-sectional study

BackgroundThe burden of chronic diseases has become a major public health concern, and high-efficiency use of community health services is essential in combating chronic diseases. This study described the status of chronic diseases in southern China and explored the determinants of health service utilization among adult residents.MethodsData were obtained from one part of community survey data from four counties in Ganzhou City, southern China. A multistage, stratified random sampling method was used to conduct a cross-sectional survey between 2018 and 2020. Overall, 7430 valid questionnaires were collected. A lasso-linear regression analysis was performed to explore the determinants of community health service utilization.ResultsAccording to the study, most participants (44.6%) reported having relatively good health, while 42.1% reported having moderate health. Chronic diseases were reported by 66.9% of the respondents. The three most prevalent self-reported chronic diseases were hypertension (22.6%), hyperlipidemia (5.9%), and diabetes (5.9%). Among residents with chronic diseases, 72.1% had one chronic disease, while the rest had multiple. Only 13.9% of residents frequently utilized community health services, while 18.9% never used them. Additionally, among residents who reported having chronic diseases, 14.1% had never attended community health services. Four categories of factors were the key determinants of community health service utilization: (1) personal characteristics, age, and sex; (2) health-related factors, such as family history, self-reported health conditions, and the number of chronic diseases; (3) community health service characteristics, such as satisfaction with and accessibility to community health services; and (4) knowledge of chronic diseases. Specifically, women tend to utilize healthcare services more frequently than men. Additionally, residents who are advanced in age, have a family history of chronic diseases, suffer from multiple chronic conditions, rate their self-reported health condition as poor, have a better knowledge about chronic diseases, have better accessibility to community health services, and have higher the satisfaction with community health services, tend to utilize them more frequently.ConclusionsGiven the limited healthcare resources, the government should promote the effective utilization of community health facilities as a critical community-based strategy to combat the growing threat of chronic diseases in southern China. The priority measures involve enhancing residents’ access to and satisfaction with community health services and raising awareness of chronic illnesses among older individuals with poor health status.